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  • Text-To-Verify: 1 (855) 999-7896

Validation Task Force form--Electrical Work Statewide

This form must be submitted by the person authorized to attend the three sessions. (* indicate that a field is mandatory)
  • Enter your first and last name
  • Enter the name of your company
  • Enter your position and title
  • Enter your LSLBC license #
  • Enter your work address
  • Please enter a number from 0 to 100.
  • Please describe prior experience as it relates to Electrical Work. Type "NA" if this does not apply to you.
  • Why are you interested in being a part of this Task Force?
  • Were you previously involved in the development or evaluation of the Electrical Work examination?
  • Are you able to participate in all scheduled workshops?
  • List any dates you will be unable to attend due to scheduling conflicts.
  • If you have co-workers and/or employees who may be interested in participating in the workshop, please enter their name and email address where we may send additional information.
  • By checking the "I agree" box below, I acknowledge that I would like to be considered for the Validation Task Force and agree to participate in one or more of the workshops associated with these redevelopment activities.


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